Ashtangasamgraha 8.33

Now, when the king seeking victory sets out against an enemy, the physician, well-equipped with medicines, instruments, and surgical appliances,

with his quarters marked by a tall flag, should treat the warriors returning from battle.

Increasing gradually and auspiciously through knowledge of length and through discernment.

Hemorrhoids and chronic digestive disorder are among the eight great diseases that are very difficult to overcome.

He should employ that oil in nasal errhines, in potions, and in enemas.

The first among them is cooling and wholesome, [the second] heating, and the third is medicine for sterility.

The technical conventions closely connected to therapeutics will now be declared:

The physician should boil the ingredients in sixteen times their quantity of water.

Reduced to a fourth part and strained, the decoction is considered acceptable for use.

Now, if among those decoctable ingredients a liquid other than water is specified,

that too is to be employed like water, therefore sixteen times [the quantity of drugs].

Whatever liquid is mentioned therein, whether milk, curd whey,

urine, buttermilk, the clear upper part of fermented wine, or sour gruel,

that should be sixteen times [the drugs], like water, and reduced to a fourth part.

When, however, the quantity of the decoctable substances and of the liquid is not specified,

This method for boiling decoctions has been described by Kṛṣṇātreya.

When there is an explicit instruction, indeed, it should be done precisely as instructed.

Because this general rule cannot apply to formulas such as Ṣaḍaṅga,

relying upon standard medical practice regarding the medicines and water in those cases,

the proportions should be arranged so as to correspond to the disease and other factors.

Therefore, half a pala, or three karṣas,

or even one pala of ingredients should be taken for two prasthas of water;

or those skilled in inductive and deductive reasoning may use more than that,

or even less than that. One should reason in this same way regarding soup and refreshing drinks,

as well as meat-rice dishes, asavas, ariṣṭas, and thin gruels.

Indeed, wherever a decoction is prescribed for preparing an unctuous substance and the like,

there too this view of sixteenfold [water] is adopted.

In this view, an amount of drug to be boiled equal to the unctuous substance is used,

if the decoction alone is the sole liquid there;

likewise, if another liquid such as milk is also mentioned there,

one should calculate accordingly and prepare the substance with water.

Using a decoction substance equal to the unctuous substance when another liquid is also present

is not suitable in that case; therefore, one should proportion it accordingly.

Other physicians, however, state that the substances to be boiled [should be placed] in eightfold water;

in this case, the drug to be boiled is twice the unctuous substance.

If it is to be prepared with decoction alone, as well as when another liquid is present,

one should prepare it proportionately; some describe it in this way.

One should boil the drugs with fourfold water:

such is the view of all the sages, including Suśruta and others.

Only this much is the difference here; the remaining measure is as before.

In this view, the medicine to be boiled is four times the unctuous substance.

Now, fourfold water relative to the substance by pala:

when fourfold water is taken relative to the substance by prastha,

twice the substance to be boiled relative to the unctuous substance is employed,

since a prastha of liquids is considered twice that of a dry prastha.

Indeed, standard practice among physicians here in treatment is twofold:

there is with reference to the pala, and likewise with reference to the prastha.

The ancient reading of Suśruta that was previously cited

is quoted as an authority with reference to the pala.

Thus, a threefold method has been declared with regard to obtaining a decoction.

Likewise, in all other cases, the unctuous substance is four times the paste;

the liquid is four times the unctuous substance, whichever liquid is prescribed.

When no liquid is specified, fourfold water alone should be added.

The method of paste for decoctions, however, is not stated in Caraka;

rather, the procedure for cooking unctuous substances was described in this manner by Dṛḍhabala,

since Caraka attained oneness with Brahman when the treatise was only half-completed.

Moreover, the dosage of a drinkable decoction, or of paste and powder,

was defined by Dṛḍhabala there in that manner.

It has been established by me through inference from the statements made by Caraka,

and I shall explain later how that dosage is determined, even though not stated [explicitly].

A distinction among these methods of decoction is laid down:

among the threefold methods of decoction, that which uses fourfold water

is the method of decoction adopted by physicians generally when preparing unctuous substances,

not so much the one that uses sixteenfold water.

In the view of fourfold water, the substance is four times the unctuous substance;

one hundred and twenty-eight palas of decoctible substance result

when one prastha of unctuous substance is to be cooked, if that [substance] is dry;

if it is fresh, harvested immediately, then two hundred

and fifty-six palas are used when a prastha of unctuous substance is to be prepared.

Thus, due to the abundance of substance, the method with fourfold water

is favored there, and the unctuous substance becomes more potent.

Unctuous substances boiled a thousand times and boiled a hundred times are celebrated:

even a small amount of a substance that has been well impregnated accomplishes many tasks.

Therefore, the view in which a greater quantity of substance is used

is superior in cooking unctuous substances; and this is the one adopted by me.

Its application is appropriate only in the rule for cooking unctuous substances (sneha).

Moreover, the decoctions for digestion and pacification that are mentioned in fever and other diseases,

are prescribed anew among those decoctions.

From four times [water], the drinkable decoction would be one pala;

therefore, physicians employ one pala of substance in digestive preparations.

Physicians, however, prescribe a four-pala dose of decoction to drink.

This well-established rule, handed down through tradition, is put into practice.

It cannot be contradicted, and an indicator for it is found here:

“Having boiled one pala of vatsaka seeds, one should drink the liquid.”

Thus it has been stated by the teacher Caraka in [the treatment of] diarrhea.

And in the Paṭolādya decoction, one pala of substance to be boiled is prescribed.

When there is one pala of substance, if one boils it with four times the water,

the drinkable decoction remaining as a fourth part would be one pala.

In the treatise, that large dose is also proclaimed in skin disease (kuṣṭha).

The dose of four palas of decoction that is favored by physicians,

that dose does not succeed with four times water to one pala.

This being so, four palas of medicinal ingredients would have to be cooked.

When four palas of substance are boiled in four times [water],

with a fourth remaining from the water, the drinkable decoction is four palas.

By Bhaṭṭāraharicandra it has been stated in the Kharaṇāda [commentary]:

“The dose to be drunk is six palas; its six palas of substances

are used for boiling, and the water is four times the substance.”

And in the Paṭolādya [formulation], one pala of substance to be boiled is likewise prescribed by him.

The dose stated by Kharaṇāda to be drunk is itself six palas.

That is mutually contradictory, and this is applied by him as well.

And this rule for decoction in fever and other diseases is unestablished:

six palas are not boiled, nor is the water fourfold.

Therefore, the technical definition of fourfold water is not suitable

for decoctions for fever and other diseases, for it is accepted only for unctuous substances (sneha).

The one stated by the sage Kṛṣṇātreya, which specifies sixteen times the water,

by that the taking of decoctions in fever and other diseases is carried out.

Even regarding the technical definition that prescribes fourfold water,

even there this other distinction has been adopted by some:

In unctuous preparations where there is no specification of palas,

here the water and medicine are to be counted in relation to a prastha.

And in relation to palas, the practice is also twofold.

The relation to a prastha that was mentioned earlier applies when there is an indicator.

Where a specification of palas of the substances is stated, likewise in a compound mixture (miśraka),

here the water is fourfold only in relation to the palas.

Even in Caraka, it is inferred from a statement in another context

that the dose of decoction to be drunk, even if not explicitly defined [there],

is four palas: in the formulation beginning with Svarṇakṣīrī in the treatment of anemia (pāṇḍuroga),

the dose to be drunk with cow's urine is stated to be four palas.

In the treatment of pitta-type abdominal swelling (gulma) with Rohiṇī, Kaṭukā, and others,

excluding ghee, the dose of decoction is stated to be four palas.

Therefore, from inference, the dose of four palas is established in Caraka;

and one pala of substances to be boiled is proclaimed in the Paṭolādya [formulation].

And one pala of vatsaka seed is prescribed in [the treatment of] diarrhea.

If that is not boiled in sixteen times water, then

in four times water the drinkable decoction would be [only] one pala.

Therefore, where sixteen times water is applied,

this very technical definition is inferred also for Caraka

in decoctions to be drunk, such as Mustā, Parpaṭaka, and others.

Another specific rule is also stated regarding weights in relation to dry and wet substances.

Regarding that which is cited having indicated weight in relation to dry substances:

double the weight is [taken] in liquid substances and in those freshly harvested;

this 'double weight' applies starting from a kuḍava.

Below a kuḍava, however, [the weight] of dry and liquid substances is equal.

Even in the case of a tulā, a doubled determination of measure is not desired;

a tulā is simply one hundred palas, and that is accepted for dry and liquid substances alike.

And a pala is held to be fourfold based on well-known standard indicators and the like.

In the passage, 'In the juice of a tulā of sahacara, one should cook an āḍhaka of oil,'

precisely one hundred palas is accepted here.

And this pala is four suvarṇas, not eight suvarṇas;

if the substance were doubled, a pala would be eight suvarṇas.

Neither in an añjali, nor in a prasṛta, nor in a pala, nor below a pala,

is a doubled measure accepted for liquid medicinal substances.

If doubled among liquids, a pala would become eight suvarṇas;

thereby, through doubling these, the practical course of treatment would be contradicted.

The rule for doubling liquids applies to designations beginning with kuḍava;

and an indicator regarding this exists, shown by the teacher Caraka.

This has been recited for clarity in the treatment of dermatosis:

'When an āḍhaka of water remains reduced to an eighth part, the strained juice should be taken;

and in those eight palas of decoction, four palas of clarified butter should be cooked

until eight palas remain; then it should be drunk warm.'

Now, when reduced to an eighth part, there are two sets of eight palas [= sixteen palas];

if the measure of a pala were doubled, this would not fit.

For if a pala were doubled, that would be only eight palas;

and the four palas that are prescribed to be added with clarified butter,

if the measure of a pala were doubled, that too would become eight palas.

Because a pala of dry substances is held to be four suvarṇas;

from doubling liquids, it would indeed become eight suvarṇas.

And if it were so, the specification of the dosage for an evacuating enema would be contradicted:

Beginning with half a prasṛta up to twelve prasṛtas at maximum—

this dose would be doubled if the prasṛta were doubled.

Likewise, the dose of an evacuating enema stated in the treatise is twelve prasṛtas;

that would be forty palas plus eight [= forty-eight palas].

In moderate illnesses and the like, an añjali of decoction is prescribed;

in this instruction of Suśruta, this decoction would become doubled.

What was stated by Kharaṇāda: 'One should drink six palas

of fresh juice, boiled [decoction], or cold infusion' would become twelve palas.

In paittika abdominal swelling, four palas of clarified butter is prescribed:

'One should drink it well-compounded; by it, paittika abdominal swelling is pacified.'

This dose of four palas of clarified butter would also become eight palas.

In the formulation beginning with svarṇakṣīrī, an añjali of cow's urine is prescribed;

because an añjali would be doubled, that dose would become eight palas.

And in the trāyamāṇā clarified butter for abdominal swelling, it is recited:

'Taking separately eight palas each of juice of āmalaka and sugar cane,

of milk, and of clarified butter, one should cook it thoroughly.'

Each of these eight would become sixteen palas.

Therefore, in instructions of such kind, [the measure] would be contradicted.

The doubled measure of liquids is to be applied to kuḍava and the rest;

and not for all fresh substances, even when newly gathered,

do they wish a doubled measure; and a distinction is established here:

Substances such as daśamūla are used dry;

for them alone is there a doubled measure, not for all newly gathered ones.

For those whose well-known standard practice is to use them fresh only—

as in vāsā clarified butter, vṛṣa clarified butter, and likewise in sāhacara oil—

in such cases, a doubled measure for fresh substances is not desired;

because their administration is recommended fresh only.

As for the four tulās of śatāvarī root that are prescribed,

a doubled measure is not adopted there by any physician.

For the expansion of the intellect of physicians, another [rule] is now set forth:

Where the quantity of medicinal herbs to be boiled is not stated,

and another liquid such as milk is prescribed as fourfold,

the decoction of the medicinal herbs is also to be made fourfold there.

The accepted example here is mahākalyāṇaka clarified butter.

In the very same way, where the quantity of the medicinal herbs is not stated,

and another liquid such as milk is prescribed as doubled,

the decoction of the medicinal herbs is also appropriately made doubled there.

The [formulation] beginning with vāsā, prescribed in fever, is recorded as the example here.

Where milk or another liquid is prescribed as fourfold,

and the quantity of the decoction-substances is stated, but that of the water is not stated,

there, the measure of the decoction is understood solely on the basis of the substance.

If the general rule of fourfold water is accepted there,